Anthem Inc., the second-largest U.S. health insurer by membership, said premiums for ObamaCare insurance probably will go up next year.

Anthem is eking out a small profit from selling policies to individuals under the Affordable Care Act. Many of its rivals aren’t, though, which means prices have to go up, the company told investors and analysts on Wednesday.

Other insurers are charging premiums that are “still well below what we think appropriate rates are for a sustainable environment,” Chief Financial Officer Wayne DeVeydt said on a conference call with analysts.

One of the many factors that can cause a health insurance system to fail is “adverse selection,” a phenomenon in which those who know they will make higher-than-average claims are disproportionately likely to enroll and pay premiums. The inevitable results is a rapid increase in premiums, which encourages even more marginal consumers to forgo insurance, leaving average claims, and therefore premiums, to increase even further.

One approach to limit this problem is to limit the time frame during which enrollment is permitted. Why have limited open enrollment periods? The idea is that without them – that is, if anyone could enroll in health plans whenever they want – people could “game the system,” enrolling when they need health care, and disenrolling when they don’t.

Oklahoma declined to set up an insurance exchange or to expand its Medicaid program, which has some of the nation’s most restrictive eligibility criteria. State officials say the number of private insurers participating on the federal insurance exchange here has fallen, and the premiums of the insurance plans on offer have increased.

The public’s attitude can also be an obstacle: Supporters of the Affordable Care Act often encounter stony skepticism here.

“‘Obamacare’ is a cuss word in this state,” said former Gov. David Walters, a Democrat.

Yesterday, the nonpartisan Congressional Budget Office released its annual ten-year Budget and Economic Outlook. The document contains the CBO’s updated estimates for economic growth, employment, and the nation’s fiscal health. The most notable change was to enrollment in Obamacare’s health insurance exchanges. The CBO, bowing to reality, slashed their 2016 estimates of exchange enrollment from 21 million to 13 million. Furthermore, the CBO implied that it expects exchange enrollment to peak at 16 million: a far cry from the 24 million it predicted last March.

In her confrontation with Bernie Sanders, Hillary Clinton always promises to “build on the successes” of ObamaCare, so allow us to recommend a follow-up question: What would those be, precisely? The entitlement is becoming less stable and less entrenched, not more, as it gets older.

The latest jolt is the $475 million loss UnitedHealth Group booked on the insurance exchanges in 2015, which the largest U.S. mega-insurer by membership expects to rise this year to another $500 million.

When the Affordable Care Act was drafted, the Congressional Budget Office expected people to sign up quickly for new health insurance.

Now, two years into the law, it’s clear that progress is going to be slower. The Obama administration acknowledged as much in late 2014, and again in October, when it presented its own modest predictions. Monday, the budget office also agreed, slashing its 2016 estimate by close to 40%.

Does the American public know that, buried deep in the Healthcare.gov website, the health insurance coverage available to a family gets worse as their income rises? Do people know that a family expecting to earn $51,000 in 2016 is not even allowed to buy the same coverage as a family that expects to earn $49,000?

John Podczerwinski explains what he encountered as he researched his family’s healthcare options for 2016. Under ObamaCare, when you earn more money, you receive worse health care.

UnitedHealth Group Inc. said its projected losses on the Affordable Care Act exchanges for 2016 deepened as enrollment grew despite the company’s efforts to reduce sign-ups.

The biggest U.S. health insurer said it is expecting losses of more than $500 million on its 2016 ACA plans, compared with previous projections that amounted to $400 million to $425 million in losses.

UnitedHealth had taken steps to pull back on its exchange business in anticipation of losses, including reducing marketing and slashing commissions to health-insurance agents.

The Obama administration’s top health insurance official told Congress Thursday he wants to “loosen up capital rules” to allow private investors to become part owners of the dozen surviving ObamaCare co-ops.

Andy Slavitt, the acting administrator for the Centers for Medicare and Medicaid Services which oversees the ObamaCare co-ops, told the Senate Finance Committee that his agency would also look approvingly on co-op mergers with existing insurance companies.

The new private investment policy represents a major reversal for the Obama administration, which has previously hailed the non-profit co-op health insurance model as a tool for providing competition to private, for-profit insurers.

The average ObamaCare premium rose to $408 per month for 2016 plans, about a 9 percent increase from this time last year, according to a new report from the Department of Health and Human Services.

However, 83 percent of ObamaCare enrollees pay far less than $408 because they get tax credits under the healthcare law. The average tax credit for 2016 is $294, meaning that the average share of the premiums that enrollees have to pay is $113. That is up $8 from the $105 people paid on average last year.